PURPOSE: Part two of this consensus aimed to provide recommendations for the prevention of meniscus injuries, non-operative treatment of acute tears and degenerative lesions, return to sports and patient-reported outcome measures. METHODS: This consensus followed the European Society of Knee Surgery, Sports Traumatology and Arthroscopy (ESSKA) formal consensus methodology. For this combined ESSKA-American Orthopedic Society for Sports Medicine (AOSSM)-American Academy of Sports Physical Therapy (AASPT) initiative, 67 experts from 14 countries, including orthopedic surgeons and physiotherapists, were involved. The 26 Steering Group members established guiding questions, screened the existing evidence, and proposed statements, and provided Grades of recommendations. The 41 Rating Group members assessed the statements according to a Likert scale (1-9). Final documents were assessed by an international peer review group for geographical adaptability. RESULTS: Low to moderate scientific level of evidence was available, so that grades of recommendations were low (three Grade A ratings, four Grade B, three Grade C and 13 Grade D), underlining the relevance of this consensus. One strong and 17 relative agreements with overall median of 8 (8-9) and a mean of 7.92 ± 0.37 were achieved for 23 statements on 18 questions. Prevention of meniscus injuries is possible with general knee injury reduction programmes and through avoidance of certain activities. Non-operative treatment including physical therapy is the first line approach for degenerative meniscus lesions and may be an option for some acute tears. Return to sports after meniscus tear surgery should be both criterion-based and time-based. Patient reported outcomes in combination with performance-based measures are recommended to evaluate the rehabilitation process. CONCLUSION: This international EU-US consensus established recommendations for prevention strategies, describes rehabilitation of non-operated patients and of patients after partial meniscectomy, meniscus repair and meniscus reconstruction, and establishes return to sport criteria. These updated and structured recommendations may be applied by surgeons and physiotherapists. LEVEL OF EVIDENCE: Level I, consensus.

Brandenburg Medical School Theodor Fontane Faculty of Health Sciences Brandenburg Brandenburg an der Havel Germany

Centre Médical ESSKA Office Luxembourg

Cochrane Czech Republic Czech CEBHC JBI Centre of Excellence Czech GRADE Network Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic

Department of Health and Rehabilitation Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Department of Orthopaedic Surgery Michigan Medicine Ann Arbor Michigan USA

Department of Orthopaedic Surgery University of California San Francisco California USA

Department of Orthopedic and Trauma Surgery Centre Hospitalier de Versailles Le Chesnay Rocquencourt France

Department of Orthopedic Surgery Mayo Clinic Rochester Minnesota USA

Department of Orthopedic Surgery VCU Health Richmond Virginia USA

Department of Orthopedics and Traumatology Brandenburg Medical School Theodor Fontane University Hospital Brandenburg Havel Brandenburg an der Havel Germany

Department of Orthopedics and Traumatology Hospital del Mar Barcelona Spain

Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA

Department of Physical Therapy and Human Movement Sciences Northwestern University Chicago Illinois USA

Department of Physical Therapy University of Delaware Newark Delaware USA

Department of Physical Therapy University of Pittsburgh School of Health and Rehabilitation Sciences Pittsburgh Pennsylvania USA

Department of Rehasport Sport Medicine Lab Department of Spine Disorders and Pediatric Orthopedics University of Medical Sciences Poznan Poland

Division of Occupational Therapy and Physical Therapy Division of Sports Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

Division of Physical Therapy Ohio State University School of Health and Rehabilitation Sciences and OSU Sports Medicine Research Institute Columbus Ohio USA

Isokinetic Medical Group FIFA Medical Centre of Excellence Education and Research Department Bologna Italy

Medical Faculty University Hospital of Iceland Landspitali University of Iceland Reykjavik Iceland

MS Knee Specialists Bristol UK

Osteon Orthopedics and Sports Medicine Clinic Mostar Bosnia and Herzegovina

Physiotherapy Research Laboratory University Centre of Physiotherapy and Rehabilitation Faculty of Physiotherapy Wroclaw Medical University Wroclaw Poland

Saint Michel Campus Institute of Physiotherapy of Saint Etienne Saint Etienne France

Sports and Orthopedics Research Center Anna TopSupport Eindhoven The Netherlands

Twin Cities Orthopedics Edina and Eagan Minnesota USA

Universitat Autònoma de Barcelona Institut Català de Traumatologia i Medicina del'Esport Hospital Universitari Dexeus Knee and Arthroscopy Unit Barcelona Spain

Wichita State University Ascension Via Christi Wichita Kansas USA

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